O052 - INCREASE IN SPECIALIZED PRO-RESOLVING MEDIATORS WITH TRANSITION TO FISH-OIL-FORTIFIED ENTERAL FORMULA

O052

INCREASE IN SPECIALIZED PRO-RESOLVING MEDIATORS WITH TRANSITION TO FISH-OIL-FORTIFIED ENTERAL FORMULA

M. S. Mundi^1,*, O. Mohamed Elfadil², R. Hurt^2,3, R. Martindale⁴, M. Dooley⁵, J. Dalli⁵

¹Division of Endocrinology, Diabetes, Metabolism, and Nutrition, ²Division of Endocrinology, ³Division of General Internal Medicine, Mayo Clinic, Rochester, ⁴Department of Surgery, Oregon Health Science University, Portland, United States, ⁵William Harvey Research Institute, Queen Mary University of London, London, United Kingdom

Rationale: Specialized pro-resolving mediators (SPMs) endogenously derived from omega-3 fatty acids are integral to the resolution of inflammation. Despite their recognized importance, there exists a paucity of data regarding the effects of incorporating fish oil into enteral nutrition (EN) therapy. This prospective cohort study aims to investigate the alterations in SPM levels resulting from a brief transition to a high-protein, fish oil-fortified peptide-based formula.

Methods: A pilot prospective trial was conducted to assess the effectiveness of a fish oil fortified enteral formula. A post ad hoc analysis of the SPM levels with transition to the examined formula for 2 weeks was performed and presented.   

Results: 25 volunteers (72% female, mean age 60.3±16.3 years) all of whom were receiving EN at home as source of nutrition completed study with 18 completing baseline and end of study labs.  Over 14 days, EPA and DHA plasma levels increased by median of 469% and 143%, respectively. 

Resolvin D5 levels increased from 2.9 ± 0.4 to 3.7 ± 0.4 pg/100µL, MCTR2 levels increased 1.1 ± 0.1 to 3.8 ± 0.6 pg/100µL, and Leukotiene B₄ levels increased from 1.9 ± 0.2 to 5.2 ± 0.5 pg/100µL (Figure 1).

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Conclusion: Short-term use of high protein fish oil fortified formula led to significant increase in plasma EPA/DHA and SPM levels, indicating potential to modify systemic inflammatory responses with EN.  The stimulation of SPM production is significant, as SPMs reduce neutrophil infiltration, enhance the clearance of apoptotic cells and cellular debris, and promote a pro-resolving macrophage phenotype. Furthermore, recent findings have shown that SPMs enhance muscle protein synthesis and decrease muscle protein breakdown, which may help prevent muscle atrophy in individuals receiving home EN. This study is designed as a pilot and further research is necessary to evaluate potential clinical benefits. 

Disclosure of Interest: M. Mundi Grant / Research Support from: Nestle, NorthSea, Rockfield, Consultant for: Baxter, Nutrishare, Otsuka, O. Mohamed Elfadil: None declared, R. Hurt: None declared, R. Martindale: None declared, M. Dooley: None declared, J. Dalli: None declared